Healthcare Provider Details

I. General information

NPI: 1033520945
Provider Name (Legal Business Name): JENNY HUANG
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2014
Last Update Date: 05/13/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 REDWOOD SHORES PKWY
REDWOOD CITY CA
94065-1173
US

IV. Provider business mailing address

270 REDWOOD SHORES PKWY
REDWOOD CITY CA
94065-1173
US

V. Phone/Fax

Practice location:
  • Phone: 650-631-1685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number59768
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17223
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: